persistence targeted smoking cessation in serious mental illness (smi)

Conditions: Tobacco Use; Tobacco Smoking; Tobacco Use Cessation; Tobacco Use Disorder; Schizophrenia; Schizoaffective Disorder

Summary: due to the pandemic, this study was modified from a randomized clinical trial to test the feasibility, initial efficacy, and mechanisms of action of our ptsc-s intervention to a feasibility and acceptability test of our intervention when delivered via telehealth in a single group, within-subjects design.

the investigators will test the feasibility and acceptability of a telehealth-delivered treatment designed to help smokers with serious mental illness to quit using a therapy approach focused on increasing task persistence. we will provide free, weekly individual telehealth video counseling sessions for 8 weeks and 10-weeks' worth of the nicotine transdermal patch (an fda-approved smoking cessation product available over the counter). all sessions will be video recorded for treatment integrity and supervision. the investigators hypothesize that 1) the ptsc-s intervention will be acceptable to participants, and the study will be feasible to conduct. we will report prolonged and point prevalence abstinence rates at end-of-counseling and at 3-month follow-up (co verified \<8ppm).

Eligibility criteria:
inclusion criteria: * must be between 18 - 70 years old * must indicate willingness to make a quit attempt in the next 30 days * must report being a daily cigarette smoker (including those labeled "little cigars") for past month * must have a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on the structured clinical interview for diagnostic and statistical manual (dsm), 5th edition, research version (scid-5-rv) * psychiatric illness must be stable, as indicated by no hospitalizations in previous 8 weeks, and a stable psychotropic medication regimen for 8 weeks * must have a smartphone, tablet, or computer with ability to download apps * must currently receive mental health treatment * must sign release of information for current mental health treatment providers exclusion criteria: * must not currently (in past 10 days) be taking varenicline (chantix), * must not currently (in past 10 days) be taking bupropion (zyban/wellbutrin) to quit smoking. * must not be taking any nicotine preparations (gum, lozenge, patch, spray, inhaler) daily over the last 10 days * must not report myocardial infarction, unstable angina pectoris, or significant cardiac arrhythmia (including atrial fibrillation) in the past 30 days. * women must not be pregnant, "test positive" on a pregnancy test, nursing, or planning on becoming pregnant in the next three months. women who can become pregnant may be included if using effective birth control. * must not have pending legal matters with potential to result in jail time * must not be planning on moving outside local area in next 3-months * problematic substance use in the past 3 months (alcohol use disorders identification test-concise (audit-c) ≥5 for men and ≥4 for women, drug abuse screening test (dast-10) score of ≥4) * must not have suicidal ideation in the past week with intent, plan, or access to method; must not have attempted suicide in the past year (as assessed on the scid-rv)

Keywords: tobacco cigarette schizophrenia schizoaffective disorders smoking cessation